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Open AccessJournal ArticleDOI

Platelet Glycoprotein IIb/IIIa Inhibitors Reduce Mortality in Diabetic Patients With Non–ST-Segment-Elevation Acute Coronary Syndromes

TLDR
A meta-analysis of the diabetic populations enrolled in the 6 large-scale platelet GP IIb/IIIa inhibitor ACS trials investigated whether diabetic patients with ACS derive particular benefit from platelet glycoprotein (GP) IIb-IIIa receptor inhibition.
Abstract
Background Diabetes mellitus is a major risk factor for adverse outcomes after acute coronary syndromes (ACS). Because this disease may be associated with increased platelet aggregation, we investigated whether diabetic patients with ACS derive particular benefit from platelet glycoprotein (GP) IIb/IIIa receptor inhibition. Methods and Results We performed a meta-analysis of the diabetic populations enrolled in the 6 large-scale platelet GP IIb/IIIa inhibitor ACS trials: PRISM, PRISM-PLUS, PARAGON A, PARAGON B, PURSUIT, and GUSTO IV. Among 6458 diabetic patients, platelet GP IIb/IIIa inhibition was associated with a significant mortality reduction at 30 days, from 6.2% to 4.6% (OR 0.74; 95% CI 0.59 to 0.92; P=0.007). Conversely, 23 072 nondiabetic patients had no survival benefit (3.0% versus 3.0%). The interaction between platelet GP IIb/IIIa inhibition and diabetic status was statistically significant (P=0.036). Among 1279 diabetic patients undergoing percutaneous coronary intervention (PCI) during inde...

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ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation

TL;DR: This paper presents a Randomized Assessment of Acute Coronary Syndrome Treatment of Intracoronary Stenting With Antithrombotic Regimen and Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction.
Journal ArticleDOI

Diabetes and atherosclerosis: epidemiology, pathophysiology, and management.

TL;DR: Since most patients with diabetes die from complications of atherosclerosis, they should receive intensive preventive interventions proven to reduce their cardiovascular risk.
References
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Journal ArticleDOI

Global Burden of Diabetes, 1995–2025: Prevalence, numerical estimates, and projections

TL;DR: This report supports earlier predictions of the epidemic nature of diabetes in the world during the first quarter of the 21st century and provides a provisional picture of the characteristics of the diabetes epidemic.
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Mortality from Coronary Heart Disease in Subjects with Type 2 Diabetes and in Nondiabetic Subjects with and without Prior Myocardial Infarction

TL;DR: It is suggested that diabetic patients without previous myocardial infarction have as high a risk of myocardia infarctions as nondiabetic patients with previous my Cardiac Arrest.
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Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. Results of a Veterans Administration Cooperative Study.

TL;DR: The data show that aspirin has a protective effect against acute myocardial infarction in men with unstable angina, and they suggest a similar effect on mortality.
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Aspirin, sulfinpyrazone, or both in unstable angina. Results of a Canadian multicenter trial.

TL;DR: Findings provide strong evidence for a beneficial effect of aspirin in patients with unstable angina and there was no evidence of an interaction between sulfinpyrazone and aspirin.
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Diabetes and atherosclerosis: an epidemiologic view.

TL;DR: Only a relatively small proportion of the excessive occurrence of ASVD in diabetics can be explained by the effects of diabetes on the levels of general risk factors for ASVD, but the major proportion remains unexplained and must be due to effects of Diabetes itself through mechanisms that are incompletely understood.
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